Thoracic and diaphragmatic endometriosis: an overview of diagnosis and surgical treatment

Abstract

Purpose of reviewThoracic endometriosis is a rare disease that can lead to a variety of clinical manifestations. There are currently no guidelines for optimal diagnosis and management of the disease. The purpose of this review is to provide an overview of the diagnosis and surgical treatment of thoracic endometriosis. Recent findingsVarious imaging modalities, including computed tomography (CT), MRI and ultrasound, have been reported in the detection of thoracic endometriosis. MRI is the most sensitive imaging study and may aid in preoperative planning. Histopathology of a biopsied lesion remains the gold standard for diagnosis. Surgical management of thoracic endometriosis may involve laparoscopy and/or thoracoscopy, and surgical planning should include preparation for single ventilation capability. A multidisciplinary approach involving a gynaecologic surgeon and thoracic surgeon may be considered. Repairing diaphragm defects and pleurodesis are shown to decrease recurrent symptoms.

True Prevalence of Diaphragmatic Endometriosis and Its Association with Severe Endometriosis: A Call for Awareness and Investigation

“…MRI is the most accurate imaging modality to detect DE, as well as thoracic endometriosis, with a sensitivity of 80% . (8,25,26,34,35 ). Due to the often unspecific symptoms, unclear pathogenesis, and the difficult diagnosis, more knowledge is needed about this rare disease.…”